Monocyte Count in Preterm Neonates With and Without Necrotizing Enterocolitis

Abstract

Background: Recently, blood monocyte concentration has been introduced as an inventive biomarker for necrotizing enterocolitis (NEC) in low birth weight neonate; therefore, we aimed to examine and compare blood monocyte counts in preterm neonates with and without NEC. Methods: A case-control study was conducted on 160 preterm neonates in Tehran during 2017. In this study, medical records and laboratory findings of 80 neonates with NEC (case) and 80 neonates (control), who were randomly chosen from among neonates who had survived NEC, were reviewed and CBC outcomes were compared between the groups. Results: We compared 80 cases and 80 controls. The mean gestational age in the NEC and control group was 30.78±2.33 and 31.41±2.16 weeks, respectively. The birth weights in the NEC and control group were 1500±488 and 1562±360 g, respectively. The mean age for developing NEC was 14.14±13.9 days. The absolute neutrophil count (ANC) and absolute lymphocyte count (ALC) did not differ statistically significantly between the two groups. The mean absolute white blood cells (WBC) in the NEC and control group were 11368±7957 and 8268±7505, respectively; absolute WBC was significantly different between the two groups (P=0.001). The mean absolute monocyte count (AMC) in the NEC and control group were 262±193 and 518±691, respectively; the difference in absolute WBC was significant between the two groups (P=0.002). Receiver operating characteristic of AMC values showed a diagnostic accuracy of 0.693 (95% CI: 0.612–0.773) for NEC and 0.738 (95% CI: 0.627–0.850) for stage II and III NEC. Conclusion: The result of this study suggest that the concentration of blood monocyte could be an indicator for NEC in the preterm neonate. However, this result should be confirmed by other studies.

Reduction of absolute monocyte counts is associated with the severity of preterm necrotizing enterocolitis

“…Next, the authors also found that the more severe the NEC stage, the lower AMC and the greater the reduction of AMC at the onset. In the present study, there were statistical differences between stage 1 and stage 2, stage 1 and stage 3, but there was no statistical difference between stage 2 and stage 3, which was different from the results of Desiraju et al 23 and Tajalli et al 14 At recovery, AMC was highest in stage 3, followed by stage 2, and lowest in stage 1, although there was no statistical difference.…”

“… 11 When intestinal inflammation occurs, blood monocytes, as the only source of intestinal monocyte-derived macrophages, need to migrate extensively to the gut. 12 , 13 Meanwhile, in infants with NEC, the absolute monocyte counts (AMC) decreased in varying degrees, 11 , 14 , 15 also associated with mortality in NEC. 16 The activation of monocytes participates in the development of NEC, 17 , 18 and blocking NF-κB activation in Ly6c + monocytes alleviates NEC.…”

The Role of Monocyte Count in Predicting the Severity of Necrotizing Enterocolitis in Egyptian Preterm Neonates: A Multicenter Study

“…Predicting the severity of NEC in preterm neonates is crucial for timely intervention and management [6]. The monocyte count, which is a type of white blood cell, has been investigated as a potential biomarker for predicting the severity of NEC [1].…”

“…NECROTIZING enterocolitis (NEC) is one of the most serious and common gastrointestinal medical/ surgical emergencies in preterm neonates, which affects 6%-7% of extremely low birth weight neonates. NEC is one of the major causes of mortality in neonates born prior to 32 weeks of gestation or with birth weight less than 1500 grams [1].…”

“…Monocyte-derived intestinal macrophages participate in the gut wall infiltration classically seen in NEC and once infiltration occurs, peripheral blood monocytes may be called upon to replete the intestinal monocyte pool Awareness of diagnostic problems and lack of a valid and measurable biomarker for early diagnosis of NEC forces specialists to treat neonates with abdominal and perilous symptoms, which is an expensive and unpleasant approach. Therefore appropriate and rapid diagnostic methods are needed to prevent unnecessary treatments [1].…”